| NPI | 1902110026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4855TP) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007628) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2013-10-17 |